Equipi

TERRITORY AND EXPERTS EQUIPI - Web Based Equipment Purchase and Rental System Cindy Eason I Integrative Studio 2 I Spring 2016

BACKGROUND INFORMATION AND PROCESS Healthcare is one of the most hazardous professions in terms of non fatal injury, more than construction or manufacturing from the Bureau of Labor Statistics. Healthcare also faces increased changes and costs related to patient care. In an attempt to provide a solution to this problem of increased workers’ compensation costs and hospital operational costs, my design research has been centered around providing a solution to this problem, by creating an opportunity for increased equipment into the system, enabling the patient to move from one level of care to the next seamlessly, and more equipment for moving and lifting patients to prevent hospital worker injury.

Currently there are no systems that provide case management and nursing, providing a transparent and efficient system for ordering equipment in healthcare for the acute or sub-acute setting. Some dialysis companies like DaVita and Fresenius have their own internal ordering systems, but they are inefficient and do not provide the equipment quickly needed to prevent length of stay costs. The status quo consists of using an internet search engine, or pulling a phone book to call and order equipment over the phone. The system I am proposing, is one that is web based, providing all one needs to order equipment via the internet, with immediate pricing, availability and delivery information. The advantage for large and small equipment suppliers is they will have immediate real time inventory tracking, with some metrics for their business that can also aid in forecasting trends to business catch opportunities.

This document includes my continued research and design of this project around territory and experts. I have interviewed numerous nurses, and posted surveys and include information from four case studies relevant to my project revealing some interesting information. I am also an expert in nursing healthcare with 21 years of nursing experience to include case management, utilization management, and intensive care in four level one trauma centers. I have used design the methods of User Journey Map and Content Analysis in discussions with interview subjects. The next set of slides will summarize my findings, and a web based solution called EQUIPI.

SURVEYS

SURVEYS The following questions enabled me to narrow down specific information needed to assess the viability of this idea and information needed in the design process.

67% answered Yes

Does your facility or business frequently encounter losses around length of stay, not covered by Medicare, related to equipment unavailability?

Range from $1,500 to $500,000 USD yearly

What estimated losses are incurred by your business or facility around length of stay, related to equipment unavailability?

54% answered YES

Does your business or acute facility have a preventative worker compensation program with more lifting and transport equipment?

Range from $10,000 to $2,000,000 USD yearly

What percentage of costs are incurred, of worker compensation cases by your acute facility or business on a yearly basis?

91% answered YES

Would you be interested in using a system where equipment inventories and availability are transparent, through a web based purchase system to improve your bottom line regarding equipment availability, promoting a safe workplace and prevent length of stay costs?

Range from $1,000 to $15,000 USD monthly

What monthly fee would you invest for your business or facility, to prevent such costs related to equipment needs?

Varied responses to include compliance & customer support

What feedback do you have regarding this web based system?

Survey Findings https://ceason.typeform.com/report/bB8wgl/YZIj

91% Of those respondents of acute care, stated they possibly would be interested in a web based system for ordering equipment and tracking.

64% Of those respondents stated they have a worker compensation preventative program with more lifting and transport equipment.

67% Of those respondents stated they have encountered loses regarding length of stay around equipment unavailability.

SURVEYS REVEALED: The surveys posted targeted Case Management and Hospital Administration (CEO’s, CFO’s, Director of Nursing, Nursing Executive Officer) in an effort to find business opportunity, and the viability of this potential product. Sixty four percent stated they have a preventative worker compensation program which reveals they would be a potential consumer of this product and 67% of those who responded stated they have incurred losses around length of stay related to equipment unavailability, again more evidence this product would add value by decreasing their bottom line. Ninety one percent stated they would try this product, and expressed they would invest a monthly fee amount to decrease their operating costs.

INTERVIEWS

INTERVIEWS

The nurses and healthcare professionals interviewed all like myself, have over 20 years of experience and in some cases, over 30 years of healthcare experience.

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Becky Hiott Proctor BS MS stated she has encountered in the past where a bariatric patient could not advance another level of care because the proper equipment was not available.

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Marcia Morgan, RN BSN stated ”there is not system to make discharge planning easier, dc planning is a hard job and stated she has encountered losses due to increased length of stay when some equipment is not available.”

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Sharon Hewat, RN BSN (third interview) Revealed she has encountered a 25% increase in length of stay cost related to equipment unavailability for quadriplegic, bariatric and any hard to obtain specialized equipment needed to advance to the next level of care.

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Kathy LaMunyon RN (second interview) Stated in her past experience she has encountered increased length of stay costs, not getting equipment she needed for patients to discharge home.

INTERVIEWS Sally Jones Saez RN, BSN-Background, Emergency Room, ICU and Case Management, over 20 years of nursing experience.

Discussed this concept of equipment supply and her response was to share an example of an existing business that provides Home Health service for people who provide services outside of Medicare to meet people’s needs. She explained of an existing home health service where out of pocket payment for services not using traditional Medicare to obtain services otherwise deemed medically unnecessary by. Her thoughts around medical equipment service to prevent length of stay from a case management point of view are beneficial.

Kelley Handler RN-Background ICU, Emergency Room, Case Management and Utilization Management, over 20 years of nursing experience.

Conversation with Kelley revealed having a vehicle to help decrease length of stay for the acute and sub-acute hospital when equipment needs are a barrier to admission or discharge would be beneficial. This system would make the movement of patients more of a liquid process and facilitate movement.

Sharon Hewat, RN BSN Background Home Health, Acute Inpatient Rehabilitation and UM, over 20 years of nursing experience.

Kathy Lamunyon RN-Background OBGYN, Long Discussed this concept with Sharon and she mentioned Term Acute Care Hospital and UM, over 30 years the current competitive bidding program and the need of nursing experience. for face to face encounter needed for obtaining equipment. I explained this equipment obtainment will Kathy stated any system who helps a facility obtain be from the facility and not from the individual, and not equipment to prevent discharge to another facility are subject to the same regulation. beneficial. Having a background in post acute care She also shared a business concept by a physician who and UM, she stated the lack of bariatric equipment has a healthcare business that does not use insurance poses the largest challenge to post acute facilities. reimbursement system for his clients, but provide a service where medical necessity is not used and pay out of pocket for services. She stated this concept of equipment availability would beneficial since most nurses have some kind of injury.

Conclusions From Nurse and Healthcare Professional Interviews

Interviews with experts revealed this business concept is viable and there is business opportunity for a web based system like EQUIPI.

CASE STUDIES

CASE STUDIES The following case studies and white papers prove a preventative injury program and prevention of extended length of stay is cost effective in the hospital setting.

The Journey to Safety: The Business Case for Investment in Safety – A Guide for Executives

Using Tracking Tools to Improve to Improve Patient Flow In Hospitals

Facts About Hospital Worker Safety

Case Study: Average Length of Stay Reduction

Case Studies Revealed Case studies support and solidify a sound business case to support implementation of a safer workplace and decreasing length of stay will have a positive impact on a hospitals bottom line.

Conclusions and Business Opportunity Currently a system like this does not exist in healthcare, creating a business opportunity and aiding the acute care settings in compliance with current OSHA recommendations, and helping the acute hospital capture and resolve costly length of stay costs, not covered by Medicare.

This system will also aid nursing staff in streamlining their daily processes, implementing greater efficiency which will also impact the acute bottom line and further proving this system is a viable business opportunity.

From continued research of territory and experts using surveys, interviews and case studies focusing in the southeast region of the USA, initial research supports this could be a viable solution to aid hospitals in reducing operating costs related to increased length of stay and worker compensation.

THANK YOU!

References: Bureau of Labor Statistics. PDF table: Highest rates for total cases-Injuries and Illnesses-2013. Available at :bls.gov./lif/oshsum.htn. Accessed September 13, 2015.

Centers for Disease Control Workplace. Safety and Health Topics-Safety Patient Handling. Available at cdc.gov/micsh/topics/safepatient/. Accessed September 13, 2015.

Google Images. Available at google.com. Accessed September October, and November 2015.

Luck, Rachael. “Design Research: Past, Present and Future.” Design Research Quarterly. September 2006. pp 19-20. Available at Design Research Quarterly Archives. drsq.org. Accessed September 9, 2015.

Nelson, Audrey PhD RN et al. “Myths and Facts About Back Injuries in Nursing.” American Journal of Nursing. February 2003. Volume 103. Issue 2.pp 32-40. Accessed September 13, 2015.

Zwerding, David. “Hospitals Fail to Protect Nursing Staff from Becoming Patients.” National Public Radio Website. 2015. Available at npr.org/2015/02/04/382639199/hospitals-fail-to-protect-staff.

Accessed September 13, 2014.

Zwerding, David. “OSHA Launches Program to Protect Nursing Employees.” NPR Website. Available at npr.org/sections/the two-way/2015/06/24/417186384/osha-launches-program-to-protect-nursingemployees. Accessed June, September, October 2015.

References: Lambert,Lynda,RN. “Nurses: You’ve Been LIED to about your Back and Body Mechanics.” Available at allnurses.com/general-nursing-discussion/nurses-you-ve-980933.html. Accessed October and November 2015.

Martin, Bella and Hanington,Bruce. Universal Methods of Design. Rockport Publishers. 2012.

Tufte,Edward R. The Visual Display of Quantitative Information. 2nd Edition. Graphics Press.LLC .2001.

United States Department of Labor. Guidelines for Nursing Homes. Available https://www.osha.gov/ergonomics/guidelines/nursinghome/final_nh_guidelines.html. Accessed October 2015.

Design Research Techniques www.designreserchtechniques.com Successful Approaches to Reducing Occupational Musculoskeletal Disorders within the Healthcare Industry. PDF. Web. Feb 10, 2016. www.osha.gov.

Worker Safety in Your Hospital. PDF. Web. Feb 10, 2016. www.osha.gov.

Improving Patient and Worker Safety. Web. Feb 10, 2016. www.jointcommision.com.

References: 2013 Hospital Workers’ Compensation Benchmark Study. PDF. Web. Feb 10, 2016. www.beechercarlson.com.

Case Study : Average Length of Stay Reduction. PDF. Juran Healthcare. Web. Feb 10, 2016. www.juran.com.

Using Tracking Tools to Improve Patient Flow in the Hospital. PDF. California Healthcare Foundation. Web. Feb 10, 2016. www.chcf.org.

Understanding the Problem-Worker Safety in Hospitals. United States Department of Labor. Web. Feb 10, 2016. www.osha.gov.

The Business Case for Investment in Safety-A Guide for Executives. PDF. National Safety Council. Web. Feb 11, 2016. www.nsg.org.